How much rates vary
Facilitymedian $1,660 · 10th to 90th $224 to $5,012Professionalmedian $132 · 10th to 90th $98 to $234
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $120.23 Median $199.53 Typical High $5,011.87 | Facility | None | $120.23 | $199.53 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $199.53 | Professional | None | $107.15 | $147.91 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $125.89 | Professional | None | $89.13 | $89.13 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $3,162.28 Typical High $5,888.44 | Facility | None | $602.56 | $3,162.28 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $162.18 | Professional | None | $95.50 | $114.82 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $776.25 | Facility | None | $114.82 | $114.82 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $616.60 Typical High $1,174.90 | Facility | None | $389.05 | $616.60 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $380.19 | Professional | None | $107.15 | $173.78 | $380.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $309.03 Median $870.96 Typical High $2,089.30 | Facility | None | $309.03 | $870.96 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $288.40 | Professional | None | $120.23 | $199.53 | $288.40 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $269.15 | Professional | None | $100.00 | $151.36 | $269.15 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $72.44 Typical High $81.28 | Professional | 52 · Reduced service | $53.70 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $28.84 Typical High $32.36 | Professional | 53 · Discontinued | $21.38 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $107.15 Typical High $123.03 | Professional | 54 · Surgery only | $79.43 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $21.38 Typical High $24.55 | Professional | 55 · Aftercare only | $15.85 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.45 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.72 | $14.45 | $16.22 |
Where Indiana sits
The same service costs 6.3 times more in New York than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
NY $2,712MT $427
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.